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1�� MANCT-1 OP ID: KR , `..•/ CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE °"'� ` "' ` 08//24/12411 "2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT : If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy , certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorseme s . CONTAPRODUCER 772-286113 NAME: Cabot Lord _ Stuart Insurance, Inc- 772-286-9389 PHONE 772-28611334 3070 S W Mapp H No Ext : _ ac No): 772-286-9389 Palm City FL 34990 �E�: clord@stuartinsurance. net Cabot W Lord, CIC . — — INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A : Westfield Insurance 124112 relce, nC.INSURED ncils rc INSURER B : 4551 SE Hampton Ct. - Stuart, FL 3497 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NSRADDL WEIR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M MMID LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 19000, 00 A X COMMERCIAL GENERAL LIABILITY X TRA7416829 02/04!12 02/04/13 PREMISES Ea occurrence $ 150100 CLAIMSWADE a OCCUR MED EXP (Any one person) $ 10 ,00 PERSONAL & ADV INJURY $ 1 ,000 ,00 GENERAL AGGREGATE $ 21000100 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 20000,00 17 POLICY I X I PROT F7 LOC $ AUTOMOBILE LIABILITY COMBINED SIR?;�� Ea accident $ 1 ,000,00 A X ANY AUTO TRA7416829 02/04112 02104/13 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-0VoNED PROPERTY Per $ HIRED AUTOS AUTOS accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1 ,000 ,00 A EXCESS UAB CLAIMS-MADE TRA7416829 02/04/12 02/04/13 AGGREGATE $ 11000 ,00 DED I X I RETENTION $ 0 Prod/COA $ 11000900 WORKERS COMPENSATION V C STATU- OTH- AND EMPLOYERS LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT $ OFFICEMMEMBER EXCLUDED ? ❑ N / A (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ K yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ A Inland Marine TRA7416829 02/04/12 02/04/13 Rented 2251 equip. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, H more space is required) GRADING OF LAND / State of Florida CERTIFICATE HOLDER CANCELLATION IRCBC -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Indian River County ACCORDANCE WITH THE POLICY PROVISIONS. Board of County Commissioners 1840 25th Street AUTHORI7EDREPRESENTATIVE _ - - - Vero Beach , FL 32960 ( 4e © 1988-2010 ACORD CORPORATION . All rights reserved . ACORD 25 ( 2010/05) The ACORD name and logo are registered marks of ACORD